﻿<!DOCTYPE html>
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    <title></title>
    <link rel="stylesheet" href="../source/layui-v2.5.6/css/layui.css">
    <link href="../source/css/primary.css" rel="stylesheet"/>
    <link href="../window/css/enter_win.css" rel="stylesheet" media="screen" />
    <script src="../source/js/common_url.js"></script>
    <script src="../source/js/util.js"></script>
    <script src="../source/jquery/dist/jquery.min.js"></script>
    <script src="../source/My97DatePicker/4.8/WdatePicker.js"></script>
    <script src="../source/layer/layer.js"></script>
    <script src="../window/js/enter_win.js"></script>

</head>
<body>
    <div class="">
        <form class="form-horizontal form-enter">
            <div class="layui-form-item">
                <label class="layui-form-label">患者ID:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="input_paientId" name="input_paientId">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">识别号:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="input_hospitalNo">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">患者姓名:<span class="mstfill">*</span></label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="input_paientName">
                </div>
            </div>
             <div class="layui-form-item">
                 <div class="layui-input-inline">
                     <label class="layui-form-label">性别：<span class="mstfill">*</span></label>

                     <select  id="select_sex">
                         <option value="1">男</option>
                         <option value="0">女</option>
                     </select>
                 </div>
                 <div class="layui-input-inline">
                     <label class="layui-form-label"> 年龄：<span class="mstfill">*</span></label>

                     <input type="text" class="layui-input" id="input_age" onkeyup="this.value=this.value.replace(/\D/g,'')" onafterpaste="this.value=this.value.replace(/\D/g,'')">
                 </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">临床诊断:</label>
                 <div class="layui-input-block">
                    <textarea class="layui-textarea" id="text_diagnosis"></textarea>
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">检查项目:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="select_examinationProject">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">检查部位:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="select_examinationCheckpoint">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">申请医生:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="select_applyDoctorName">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">申请科室:</label>
                 <div class="layui-input-block">
                    <input type="text" class="layui-input" id="select_dept">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">申请时间:</label>
                 <div class="layui-input-block">
                    <input type="text" style=" background-color:#ffffff;" readonly class="layui-input" id="input_applyDate" name="input_applyDate" onclick="WdatePicker({ dateFmt: 'yyyy-MM-dd H:mm:ss ' })">
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">子系统：<span class="mstfill">*</span></label>
                 <div class="layui-input-block">
                    <select id="select_sysName" onchange="queryQueueList();">
                        <option value=""></option>
                    </select>
                </div>
            </div>
             <div class="layui-form-item">
                 <label class="layui-form-label">队列名称:<span class="mstfill">*</span></label>
                 <div class="layui-input-block">
                    <select id="select_queue" onchange="changeDocList();"></select>
                </div>
            </div>
            <div class="layui-form-item slt-docs">
                <label class="layui-form-label">医生:<span class="mstfill">*</span></label>
                <div class="layui-input-block">
                    <input type="hidden" id="ipt-doctor" />
                    <select id="select_doctor"></select>
                </div>
            </div>
        </form>
    </div>
</body>
</html>
